a. Screening and management of chronic complications in children and adolescents with type 1 diabetes

i. Nephropathy

ii. Hypertension

iii. Dyslipidemia

iv. Retinopathy

v. Celiac disease

vi. Hypothyroidism

b. Self-management

c. School and day care

d. Transition from pediatric to adult care

2. Type 2 diabetes

3. Monogenic diabetes syndromes

B. Preconception care

C. Older adults

D. Cystic fibrosis–related diabetes

VIII. DIABETES CARE IN SPECIFIC SETTINGS, p. S43

A. Diabetes care in the hospital

1. Glycemic targets in hospitalized patients

2. Anti-hyperglycemic agents in hospitalized patients

3. Preventing hypoglycemia

4. Diabetes care providers in the hospital

5. Self-management in the hospital

6. Diabetes self-management education in the hospital

7. Medical nutrition therapy in the hospital

8. Bedside blood glucose monitoring

9. Discharge planning

IX. STRATEGIES FOR IMPROVING DIABETES CARE, p. S46

Diabetes is a chronic illness that requirescontinuing medical care andongoing patient self-managementeducation and support to prevent acutecomplications and to reduce the risk oflong-term complications. Diabetes care iscomplex and requires that many issues,beyond glycemic control, be addressed. Alarge body of evidence exists that supportsa range of interventions to improvediabetes outcomes.

These standards of care are intendedto provide clinicians, patients, researchers,payors, and other interested individualswith the components of diabetescare, general treatment goals, and tools toevaluate the quality of care. While individualpreferences, comorbidities, andother patient factors may require modificationof goals, targets that are desirablefor most patients with diabetes are provided.These standards are not intendedto preclude clinical judgment or more extensiveevaluation and management of thepatient by other specialists as needed.For more detailed information aboutmanagement of diabetes, refer to references1–3.

The recommendations included arescreening, diagnostic, and therapeutic actionsthat are known or believed to favorablyaffect health outcomes of patientswith diabetes. A grading system (Table 1),developed by the American Diabetes Association(ADA) and modeled after existingmethods, was utilized to clarify andcodify the evidence that forms the basisfor the recommendations. The level of evidencethat supports each recommenda-tion is listed after each recommendationusing the letters A, B, C, or E.

These standards of care are revisedannually by the ADA’s multidisciplinaryProfessional Practice Committee, incorporatingnew evidence. Members of theProfessional Practice Committee and theirdisclosed conflicts of interest are listed onpage S97. Subsequently, as with all PositionStatements, the standards of care arereviewed and approved by the ExecutiveCommittee of ADA’s Board of Directors.